Fish oil shows little effect on Tourette's tics

NEW YORK (Reuters Health) - Some parents swear by fish oil as a treatment for the "tics" caused by Tourette's disorder, but so far the research evidence is slim.

In a small study of children with Tourette's, researchers found that omega-3 fatty acids were no better than a placebo at reducing the severity of tics -- the sudden, involuntary movements or vocalizations that mark Tourette's.

On the other hand, children who took omega-3 did show an improvement in the degree to which their tics bothered them, researchers report in the journal Pediatrics.

For now, it's not clear what to make of the findings, according to lead researcher Dr. Vilma Gabbay, of the NYU Child Study Center in New York City and the Nathan S. Kline Institute for Psychiatric Research in Orangeburg, New York.

It's possible that the omega-3 supplements affected the children's well-being, said Gabbay.

There is evidence, for example, that omega-3s can help lift depression symptoms.

But the study was small and had other limitations. And the bottom line, Gabbay said, is that larger trials are needed to see whether there might be a role for omega-3 supplements in managing Tourette's.

The condition, also known as Tourette syndrome, is a neurological disorder that affects about one percent of the population. The characteristic tics usually start in childhood, and include actions like repeated throat-clearing, rapid blinking or mouth twitching.

Despite the popular media image, most people with Tourette's do not uncontrollably hurl obscenities or slurs.

Many children with Tourette's do not need any special treatment. But some kids have symptoms that interfere with their daily life, or have additional conditions that may warrant treatment, such as obsessive-compulsive disorder.

"The problem is, the medications currently used are very hard to tolerate, or sometimes just don't work," Gabbay told Reuters Health.

Some of those medications include antidepressants, anti-seizure drugs and antipsychotics. Their side effects can range from weight gain to fatigue to depression.

Anecdotally, Gabbay said, some parents have claimed that omega-3 supplements help control their children's tics.

Omega-3 fatty acids are found largely in oily fish, like salmon, mackerel and tuna -- as well as fish oil pills.

There are biological reasons to believe that omega-3s could help quiet Tourette's tics, Gabbay said. Lab research suggests, for example, that the fats affect certain brain chemicals involved in nerve-cell communication and inflammation, and also thought to be involved in Tourette's.

But this is the first clinical trial to pit fish oil against a placebo to test it objectively.

Gabbay and her colleagues randomly assigned 33 children and teenagers with Tourette's to take either fish oil capsules or placebo capsules that contained olive oil. Depending on their age, the kids on fish oil took 500 or 1,000 milligrams of omega-3 a day.

After 20 weeks, the study found, kids in both groups were showing improvements in their tic severity. But the fish-oil group did no better than the placebo group.

However, kids on fish oil were more likely to report improvements in well-being and the impact their tics were having on their lives.

More than half were considered "responders" on that front, versus between one-quarter and one-third of kids in the placebo group.

Exactly what all that means is unclear.

It's possible, according to Gabbay, that omega-3s affected how kids perceived their tics, even though there was no clear effect on tic severity.

But, she said, "I'm not going to tell parents that omega-3s are the magic pill."

A larger clinical trial is needed, according to Gabbay. And it would probably be wise to use a different placebo, she noted.

Olive oil is not an ideal placebo, Gabbay explained, because it can indirectly affect the body's levels of omega-3 fatty acids.

Something like corn oil would be a "better placebo," she said.

For now, Gabbay recommended that parents pay attention to the amount of omega-3 fatty acids in their children's diets. If you can get them to eat more fish, that would be a good way to boost their omega-3 intake.

The typical American diet, including that of kids, tends to be low in omega-3 and high in omega-6 fats -- which are found in margarine, vegetable oils and an array of snack foods, sweets and fast food. And that imbalance is thought to be generally unhealthy, Gabbay pointed out.

If you can't get your child with Tourette's to eat fish, omega-3 capsules might be worth a shot, according to Gabbay. "But don't have the expectation that it will benefit tic severity," she said.

A month's supply of one-gram fish oil capsules can run well over $15.

The supplements seem to be generally safe, Gabbay noted. She and her colleagues found no higher risk of side effects in kids using fish oil compared with the placebo group.